Household survey: HIV prevalence increases

Antiretroviral treatment has given HIV-infected people a longer life, thus increasing the proportion of people living with HIV.

The proportion of South Africans infected with HIV has increased from 10.6% in 2008 to 12.3% in 2012, according to the Human Sciences Research Council (HSRC).

The HSRC released the results of a 2012 household survey at the 6th SA Aids Conference in Durban this week.

HIV prevalence increased in all provinces in the age group 15 to 49 years with the highest proportion of infections in Kwazulu-Natal at 27.6% and Mpumalanga at 26%. Although the Western Cape has the lowest HIV prevalence, the proportion of HIV infections in the province almost doubled from 5.2% in 2008 to 9.2% in 2012.

The survey is the fourth national population-based survey and was also conducted in 2002, 2005 and 2008. Just under 68% of the 37 021 South Africans interviewed for the study agreed to be tested for HIV for the purposes of the survey.

Olive Shisana from the HSRC said "a disturbing finding" is that HIV prevalence among unmarried people is twice that of married people – 19.2% compared with 9.8%. "The proportion of unmarried persons in SA is high at 69.4% of the population aged 16 years [the legal age of marriage] and older," she said.

The survey showed that unmarried people also have more multiple sexual partners (two or more) than married people – 17.9% compared to 3%.

Expanding ARV programme
According to health department deputy director general Yogan Pillay the increase in HIV prevalence could be due to the government's rapidly expanding antiretroviral treatment (ART) programme. The study has found that about two million (31.5%) of the 6.4-million HIV infected people in SA is now on ART. "ART makes people live longer, so we now have more HIV-infected people who survive and thus a bigger proportion of people with HIV," he said.

Pillay, however, pointed out that "we would only be able to fully understand the reasons behind the increase in infections once we have results on the HIV incidence [the rate at which new HIV infections have increased]."

The household survey will only release HIV incidence results later this year. The study also found that, while more people are aware of their HIV status, condom use has declined in all age groups.

In 2008 85.2% of males between 15 and 24 said they were using a condom during their last sexual encounter, but only 67.4% reported doing so in 2012. Just over 40% of all circumcised males in SA have been medically circumcised. Research studies have shown that heterosexual men who have been medically circumcised are 60% less likely to get infected with HIV.

During medical circumcision the entire foreskin of the penis is removed, while often only part of it is removed in traditional circumcisions. According to the national health department's deputy director for male circumcision, Dayanund Loykissoonlal, almost a million South African men between 15 and 49 have been medically circumcised since the department launched its medical circumcision campaign in April 2010.